Revision of an anterior cruciate ligament (ACL) reconstruction can be performed as a one-stage or two-stage surgery. Several factors must be taken into consideration when making this choice, especially the size and position of the existing tunnels. When the tibial tunnel is semianatomic, it is difficult to make a new tunnel in the correct position without overlapping the existing tunnel. For this reason, we have developed a one-stage ACL revision surgery that uses a bone allograft plug. When it comes to choosing a reconstruction technique, we believe that combined intra-articular and extra-articular reconstruction with the iliotibial band is suitable when the hamstring tendons are not available, combined with clinical findings of translational and rotational instability. Because the existing tunnels require reorientation, a new femoral tunnel can be created by outside-in drilling to eliminate the risk of overlap, while an allograft bone plug can be used to fill the overly anterior tibial tunnel and allow us to drill the correct tibial tunnel right away. In our hands, this is a safe and effective technique, but longer follow-up is needed to validate its indications.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8897652 | PMC |
| http://dx.doi.org/10.1016/j.eats.2021.11.019 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Outcomes of All-Inside Arthroscopic ACL Reconstruction with Lateral Extra-Articular Tenodesis (ACLR + LET).
Indian J Orthop
January 2025
Department of Orthopaedics, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneshwar, Odisha 751024 India.
Background: Anatomic single-bundle ACL reconstruction (ACLR) produces good results when the graft and tunnel are positioned in the anatomic footprint on the femoral and tibial insertion sites in a more oblique orientation. The of the knee and its biomechanical role in controlling rotational laxity, internal rotation, and pivot shift has led to adding adjunctive procedures like extra-articular augmentation and lateral extra-articular tenodesis (LET) to decrease rotational laxity. We prospectively analyzed young adults with rotational instability and generalized laxity undergoing an arthroscopic single bundle ACLR with an additional LET procedure.
View Article and Find Full Text PDFHigh Revision Rate After Transphyseal ACL Reconstruction in Skeletally Immature Patients.
J Pers Med
November 2024
Center for Diagnostic and Interventional Radiology and Nuclear Medicine, Charité-University Medicine Berlin, 10117 Berlin, Germany.
There remains considerable debate regarding the optimal management of anterior cruciate ligament (ACL) injuries in skeletally immature patients. This study aims to evaluate the clinical outcomes of transphyseal ACL reconstruction in patients with open growth plates. This retrospective study included skeletally immature patients with full-thickness ACL tears and confirmed open physis.
View Article and Find Full Text PDFRepair of Acute Grade-3 Combined Posterolateral Corner Avulsion Injuries Using a Transosseous Krackow Suture Pull-Through Technique.
JBJS Essent Surg Tech
December 2024
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut.
Background: For complete disruption of the posterolateral corner (PLC) structures, operative treatment is most commonly advocated, as nonoperative treatment has higher rates of persistent lateral laxity and posttraumatic arthritis. Some studies have shown that acute direct repair results in revision rates upwards of 37% to 40% compared with 6% to 9% for initial reconstruction. In a recent study assessing the outcomes of acute repair of PLC avulsion injuries with 2 to 7 years of follow-up, patients with adequate tissue were shown to have a much lower failure rate than previously documented.
View Article and Find Full Text PDFPosterior Meniscal Root Repair with Epidural Needle through the Combination of Arthroscopic Portals and Transtibial Tunnel.
Rev Bras Ortop (Sao Paulo)
December 2024
Grupo de Cirurgia do Joelho e Trauma do Esporte, Complexo Hospital do Trabalhador, Universidade Federal do Paraná, Curitiba, PR, Brasil.
Posterior meniscal root repair is an expensive procedure because its performance often requires the use of specific devices. This issue is a limiting factor, especially in the public health system. Given this context, the development of alternative methods to treat these injuries became necessary.
View Article and Find Full Text PDFAnatomic Posterolateral Corner Reconstruction of the Knee Using Single Semitendinosus Autograft: Technical Note for the Borderline-length Graft.
Rev Bras Ortop (Sao Paulo)
December 2024
Serviço de Ortopedia, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.
The original LaPrade technique for anatomic reconstruction of the posterolateral corner of the knee uses two separate allografts. More recently, a modification of this technique, using an adjustable-length suspension device with a cortical button for tibial fixation, allows anatomic reconstruction with a single semitendinosus autograft. This modification is of utmost relevance when sources of allograft are not available for multiligament knee reconstruction.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!